Indianapolis - One of them most powerful women in the nation is calling for health care reform. Wellpoint CEO Angela Braly says she supports guaranteed coverage for everyone - as long as everyone gets and stays covered.

Braly addressed the Economic Club at the Convention Center Tuesday. As Forbes Magazine's eighth most powerful woman in the world, Braly is going to attract attention.

"People are very passionate about health care," she said.

Outside the Convention Center a handful of demonstrators debated that personal issue.

"If we don't do a public option, if we don't do something now, there are 48 million without insurance that will not be helped. My father is one of them," said one of the protesters.

Inside, the CEO of the nation's largest health insurer said she was concerned about several shifts, first of all in the debate.

"It has gone from a debate about health care reform to health insurance reform," she said.

According to Braly, the difference between the Medicaid or Medicare payouts and actual costs are shifted to the private plans, costing you $1,500 a year. Add that to the $1,000 a year shifted to the private plans to cover the uninsured and it costs you a total $2,500 a year.

"Sounds a lot like the Fannie Mae for health care and I think we all know how that experiment is going," Braly said.

But she also argued for change.

"The high and rising cost of health care in America is just not sustainable," Braly said. She said the current system, including Medicare, which is administered by the federal government, was inefficient and promotes quantity over quality. She also said it posed "a real threat to the social and fiscal obligations of the government and to the health and prosperity of the American people."

"We believe insurance companies have a role to play. We can and are making a difference," Braly said. She said Wellpoint's strategy was moving beyond processing claims and managing risk, noting employee incentives when customers get healthy.

Braly said private insurers need to work with the government to provide health care for an aging baby boomer population.

Braly said it was important to "refocus the debate on health care reform." She said she would support a plan requiring everyone to buy health insurance while at the same time guaranteeing everyone, including those with pre-existing conditions, would get coverage and would not be excluded.

She said such a plan "must address underlying health care costs so that coverage is affordable."

Braly talked about promoting health care consumerism to make people "better shoppers" for health care, and a field where insurers were "free to offer a range of choices. Let's not put everyone in a one size fits all plan."

Braly says the what worries her most about the plan currently under consideration is the "public option."

On the outside, a few Hoosiers had a very different perspective.

"They spent $1.2 million last month on lobbying, Wellpoint did. We don't have that kind of a budget so we have to be out there every day sending that message," said Allison Luthe, Health Care for America Now.

"If you completely eliminated insurance company industry profits which is clearly the aim of some, you would pay for two days of health care in America and in the process you would eliminate the market mechanism to control costs and improve quality of health care being delivered," Braly argued.

The key, Braly told the Economic Club, is to fix what is broken without breaking what still works.